Healthcare Provider Details

I. General information

NPI: 1730359860
Provider Name (Legal Business Name): SIPPI KAUR KHURANA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2008
Last Update Date: 03/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6624 FANNIN ST ST. LUKES MEDICAL TOWER SUITE 1410
HOUSTON TX
77030-2312
US

IV. Provider business mailing address

6624 FANNIN ST ST. LUKES MEDICAL TOWER SUITE 1410
HOUSTON TX
77030-2312
US

V. Phone/Fax

Practice location:
  • Phone: 713-790-0900
  • Fax: 713-790-0901
Mailing address:
  • Phone: 713-790-0900
  • Fax: 713-790-0901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberM7636
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberM7636
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: